Foundation Program - Opening Questionnaire

Please go through this application form and complete. Also complete the check list and tick the symptoms that currently apply to you or you are suffering from. There is a box below to add in any other issues that are not listed. There is no wrong way to complete this form it is designed to monitor the progress and improvements throughout the 12 Weeks.

Please List All Supplements & Vitamins Brands & Quantity That You Are Currently Taking Along with Dosage
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You Would Be Required To Purchase Supplements As Part Of The Program. Please Confirm You Would Be Prepared To Do So.
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Yes No

What Top 5 Things Would You Hope To Achieve Out of The Program
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How Self Motivated Are You? Please Provide An Example.
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Please provide an example of something you have committed to in the past and how you followed through?
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Have You Read The Book "Heal Endometriosis Naturally Without Painkillers, Drugs or Surgery" by Wendy K Laidlaw?
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You can purchase ebook or paperback book below

What New Pieces Of Information Did You Discover FromThe Book?
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What Steps Have You Already Taken To Try & Heal Your Endometriosis Naturally?
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This is NOT A Quick Fix Program And Requires Full 100% Commitment and Dedication Involving Lifestyle Changes over a MINIMUM of 12 Weeks- Please Explain What Makes You Sure You Would Continue for the Full Term of Program & Not Give Up?
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Fast forward 12 months from now, you're pain-FREE, symptom-FREE, feeling confident and proud, your body is looking and feeling exactly how you want it to be. How Much Are You Prepared To Invest IntoYour Body To Make This A Reality -
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What are your dreams and/or goals for your life when you are pain-free and symptom-free?

It Is 6 Months From Now-What Would Have Had To Have Happened Personally & Professionally For You To Feel A Success?
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Dream big, have faith in your AMAZING body and the Laidlaw Protocols

Where Did You Hear About Wendy?
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Google, Facebook, Word of Mouth, etc

Note:

*PLEASE NOTE - That this information is gathered for information purposes only and is not intended as medical advice, diagnosis or treatment. This information is STRICTLY confidential and is used to monitor the progress and improvement of symptoms throughout the program. It is NEVER shared with anyone else. If you have any questions at any stage please do not hesitate to contact Support@HealEndometriosisNaturally.com.